0341 (SFD)APPLICANT NAME (L F MI)
La Q=ta' Joint Vent=e
PERMIT
APPLICATION
City
of La Ouinta
Department of
Building and Safety
This permit becomes void if work not commenced within 180 days from date
of issuance. OR. if work has been suspended or abandoned for a period of 180 days.
Porch
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE: This section need not be completed if
LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9'
the permit is forone hundred ($100) o, less. I certify thatJn the performance of the -work for which this permit is I
(commencing with Section 7000) of Division -3 of the Business and Professions Code, and my license is in full force
issued, Ishall not employ any person in any manner so as ,o become subject to the Workers' Compensation Laws of
,and effect.
California.
License Class Lic. Number
Date Applicant
Date Contractor
'NOTICE TO'APPLICANT:'If, after making this Certificates Exemption, you should becomesubjecito the Workers' -
OWNER-6UIL'0'ER_ DECLARATION: ' I he,eby'aifll.rm that -I am exempt from the'Contra6tor's Licens6.Law for the
Compensation provisions of theLaborCode, you must forthwith comply with suchprovisions or this permit shall
be deemedrevoked.
c. 7031.5. Business and Professions; Code: Any city or county which.requires a permit to
following reason (Se
:I- . .
*
construct: after. improve, demolish, or repair any structure, prior to its issuance, also.requires the.applicant for
DIVISION OF -INDUSTRIAL SAFETY PERMIT CERTIFICATIC'4:
such'permit tofile a sigrked statement that he -is licensed pursuant to the p.rovisionsofthe.Co.ntra.ctor'sLicense.Ljw
01 hereby certify that no excavation five (5) or more feet i -I depth into which a pirson ii required to deicitnd:w ill'be
(Chapter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code) or that he is exempt
made in connection with work authorized'by this permit, and that no building structure; scaffolding, falsework, or
therefrom and the basis for the. alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
demolition or dismantling thereof, will be more than thirt,six,(36) feet high. (Chap 3.2, Grp 2,.'Art 2, Sec 341, Title 8,
subjects the applicant to a civil penalty of not more than five hundred dollars (5500.):
cikc.)
0 1, as owner of the property, or my employees with wages as their sole compensation, will doAhe work, and the>-,
0 As owner-6uilder, famill nofeinploy anyone to -do w3rk which would require a permit frorn.the Division of
:-"structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License
Industrial Safety; . as noted above, unless such -person tas i permit to do such work from that division.
Law does not apply to an owner of property who builds, or improves � thereon, and who does such work himself or
. . z�., . . . 1. - - . . . 41
through his own employees, provided that such improvements are not intended or offered for sale. If, however. the
0 Division of :Industrial Safety, Permit No.
building or improvennnt is sold within one year of.completion, the owner -builder will have the burden of proving that
Date -Applicant
he did not build or improve for the purpose of. sale.).
CONSTRUCTION LENDING AGENCY:A hereby affirm that teere is a construction lending agency for the performance
0 1, as owner of the property, am exculsively contracting with licensed contractors to construct the project (Sec:
of the•woWior-which thitpermit is issued (S4. 3097, Civ. C.).
7044.- Business and Professions Code: The Contractor's License Law does not apply to an owner of property who
. . .
Lender's Name
builds or improves thereon: and who contracts for such projects with a contractor(s) licensed pursuant to the
.
Contractor's License Law.).
Lender's Address
0 1 am exempt under Sec. B. & P.C. (Attached.Certificate).
I certify that I.;ave read'Ws application and state that 11 e above information is correct. I agree to comply with all
Date'Owner 4
city and county ordinances and state laws relating to bu Iding construction, and hereby authorize representatives
of this county to enter'upon the above-mentioned proprny for inspection purposes.
WORKERS" COMPENSATION DECLARATION: .1 hereby affirm that I have a certificate of consent to self -insure, ora'
,certificate of Workers' Compensation Insurance , of a'certifiedcop . y l.hereof'(Sec. 3800. Lab. C.):
.
SigKatuie of Applicant or Agent Date
Policy No Company•
•CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OFIENW: I icertify I have read this application and statdthat
O.Certified copy is hereby.*furnished. f, .
the information given is correct. I agree to comply with all state laws and county ordinances relating to buidling
0 Ceififiid'copylis filed with the City Building Inspectioh-Department or,City Department.
13V_2
-2 - " - ' - / - C
construction, and authorize. a 'representative of the Cit- of La Ouinta Department of Building and Safety to enter
upon the property for which I have applied for this permit for the purpose of making ihspections.
App icant _2 4=2L
Signature of Applicant or Agent Date
Print Applicant/Agent Name
APPLICANT NAME (L F MI)
La Q=ta' Joint Vent=e
ADDRESS
P. O. Bmc 780
CITU/COMMUNITY/STATE/ZIP
la QWintaff, CA 92253
JOB SITE AODRESS(SPACE
50-U26 Calle Rosarita
CITY/COMMUNITY/STATE/LIP
is Quanta, CA 92253
SOK
PAG '
PRC I
C,
Porch
TWN
FING
SE
S,
TR ACTL
.14496-1 1
OT
.,. I 14'
8
1
MOD
1 p-3
S8
31,25.
TRACT NAME
Santa Pbsa Savid
OWNER NAME (L. F. MI)
CONTRACTOR -FIRM NAME
ATIdM Corporaticm
ADDRESS
P. O. Box 780
CITY/COMMUNITY/STATE/ZIP
La Quanta, CA 92253
PHONE aLICNC
619-564-1-315
.333762
a
ARC/ENG FIRM NAME
'ADDRESS
CITY/COMMUNITY/STATE/ZIP
PHONE 0
IICNC
USE OF PERMIT WdMng
Su'lle Fbmily
BIL
ZON
1
FSB
SSB
SSB
RSO
OFC,
ZONE ORD #
LOT SZ
END,
'SIDE'
APPUPRMT
W. 4 1
Permit to Clanstnwt 140&1 P -3--B
DweUjmg (tat Floor)
'10,616 Sq. Ft.
(2tid Floor)
277 Sq, Ft.
Porch
112 Sq, Ft..
Garage
--1
kil
433 c.,Ft,
Mech fcal' Fee
$ 31,00'
Plan Check Flee
291,20,
Construction Fee
448,00
Eixtrric Fee
31,25.
SMI Fee
71'39
Plumbing Fee
52,50
Prcperty DevelpFeent- Fee 4501,00
TOTAL
4� FEE . 7�
I.M.34
ALUA
T
BLDG DEPT. ,Aw
''4
NO.
OPERATION DATE
INSPECTOR
NO.
OPERATION DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
/0"93
._
35
Furnace Compart.
3
Steel
36
Inlets & Outlets '
4
Grout Blocks
37
Combustion Air
5
Bond Beams
38
Compressor
6
Roof Deck
r
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Garage Fire Wall
42
Commercial Hood
10
Fireplace P. L.
❑ •
43
Final
10A
Fireplace T.O.
❑
OP'N
NO.
ADDITIONAL -INFORMATION
71191ne
�r
SEWAGE SYSTEM SIZE & LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Gradep5�
INSULATION Thick R
Value
7A Walls (Batts)
126 Ceiling (Batts)
12C Ceiling (Blown)
14 Final
PLUMBING APPROVALS
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer j
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25 Final
Tank Pit L. Line
ELECTRIC APPROVALS
REAR OF PROPERTY LINE
PSL P/1
STREET NAME
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final